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SYSTEMATIC REVIEW article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1568724
This article is part of the Research Topic Mechanisms and Complexities Underlying the Cancer Cell Immune Evasion and its Therapeutic Implications View all articles
Bispecific Antibodies Combined with Chemotherapy in Solid Tumor Treatment, the Path Forward?
Provisionally accepted- 1 Department of Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
- 2 School of Humanities and Management, Zhejiang Chinese Medical University, Hangzhou, Jiangsu Province, China
- 3 Academy of Chinese Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
- 4 Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
Background: Bispecific antibodies (bsAbs) introduced a novel strategy in anticancer therapy when chemotherapy alone could not meet life expectancy. Nonetheless, the efficacy of monotherapy was limited, and the safety profile of bsAbs combined with chemotherapy remained uncertain. Methods: Literature retrieval was carried out through PubMed, Embase, and Cochrane from inception to January, 2025. Progression-free survival (PFS), overall survival (OS), and overall response rate (ORR), along with adverse effects (AEs), were utilized to assess the efficacy and safety. Publication bias was calculated using Funnel plots and Egger's test. Heterogeneity was examined through subgroup and sensitivity analyses. The protocol was preregistered in the International Prospective Register of Systematic Reviews (CRD42025633628). Results: A total of 8 eligible clinical studies with 2,495 patients were included. Compared with chemotherapy alone, bsAb+chemotherapy exhibited positive outcomes in PFS (hazard ratio (HR): 0.52; 95% confidence interval (CI): 0.44-0.60; p<0.01), OS (HR: 0.67, 95% CI: 0.57-0.77; p<0.01), and ORR (HR: 0.31, 95% CI: 0.16-0.47; p<0.01). Subgroup analysis revealed that female patients, Asian patients, those under 65 years of age, and patients treated with IgG-like bsAb were more likely to benefit from the survival advantages of bsAb+chemotherapy. Despite the occurrence of leukopenia, metabolism-related, and skin-related AEs, RR of AEs in other systems showed no statistical significance. Conclusion: BsAb+chemotherapy was superior to chemotherapy alone, especially in female patients, Asian patients, those under 65 years of age, and patients receiving IgG-like bsAb. Additionally, while the AEs associated with bsAb+chemotherapy are generally manageable, there is still room for improvement.
Keywords: bispecific antibody, chemotherapy, Solid tumor, efficacy, Safety, Meta-analysis
Received: 30 Jan 2025; Accepted: 03 Apr 2025.
Copyright: © 2025 Yan, Yuan, Peng, Zhou, Liu, Sun and Song. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Leitao Sun, Department of Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310003, Zhejiang Province, China
Qiaoling Song, Department of Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310003, Zhejiang Province, China
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